A Guide to Implementing a Health-Based Risk-Adjusted Payment System for Medicaid Managed Care Programs

Author/Creator ORCID

Date

2003-03

Type of Work

Department

Program

Citation of Original Publication

Rights

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Abstract

This manual, prepared by The Hilltop Institute (as the Center for Health Program Development and Management) under contract with the Centers for Medicare and Medicaid Services (CMS), provides a step-by-step approach for state Medicaid programs implementing health-based risk adjustment for managed care organizations. The guide describes information system, financial, and policy issues states should consider, as well as choices related to selecting and implementing a particular methodology. The manual also discusses approaches taken and challenges encountered by other states.